viernes, 30 de mayo de 2014

Eutanasia/Euthanasia

Eutanasia y suicidio en la antiguedad: Opinión de los dramaturgos y filósofos

Euthanasia and suicide in antiquity: viewpoint of the dramatists and philosophers.
Papadimitriou JD, Skiadas P, Mavrantonis CS, Polimeropoulos V, Papadimitriou DJ, Papacostas KJ.
J R Soc Med. 2007 Jan;100(1):25-8
Although more than 3000 years have passed, the dilemma posed by euthanasia still generally divides society-a vexed question which has been debated in the medical, legal, philosophical and theological literature. In antiquity, active euthanasia and suicide were subjects of concern. Active euthanasia was rejected by the majority of both philosophers and dramatists because it was considered to be a violation of the autonomy of the individual and an action against the will of the gods. Passive euthanasia was more acceptable, either on the grounds of physical pain or out of a deep respect for the nature of human life and what fate brings to it. Even though innovations in palliative medicine can offer the best possible quality of life, there is still a minority of patients who suffer from excruciating pain, be it physical or mental. For these patients, it is the primary duty of the physician to alleviate the pain or other sufferings, provided that the doctor plays no role in initiating the course of death, at least in countries where active euthanasia is not legally permitted.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1761665/pdf/0025.pdf






Suicidio y eutanasia asistidas por el médico. ¿Puede imaginarse enseñando a sus estudiantes como terminar las vidas de sus pacientes?


Physician-assisted suicide and euthanasia: can you even imagine teaching medical students how to end their patients' lives?
Boudreau JD.
Perm J. 2011 Fall;15(4):79-84.
Abstract
The peer-reviewed literature includes numerous well-informed opinions on the topics of euthanasia and physician-assisted suicide. However, there is a paucity of commentary on the interface of these issues with medical education. This is surprising, given the universal assumption that in the event of the legalization of euthanasia, the individuals on whom society expects to confer the primary responsibility for carrying out these acts are members of the medical profession. Medical students and residents would inevitably and necessarily be implicated. It is my perspective that everyone in the profession, including those charged with educating future generations of physicians, has a critical interest in participating in this ongoing debate. I explore potential implications for medical education of a widespread sanctioning of physician-inflicted and physician-assisted death. My analysis, which uses a consequential-basis approach, leads me to conclude that euthanasia, when understood to include physician aid in hastening death, is incommensurate with humanism and the practice of medicine that considers healing as its overriding mandate. I ask readers to imagine the consequences of being required to teach students how to end their patients' lives and urge medical educators to remain cognizant of their responsibility in upholding long-entrenched and foundational professional values.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3267569/pdf/i1552-5775-15-4-79.pdf

Quitando el tabú del control para morir. Un estudio de la teoría fundamentada
De-tabooing dying control - a grounded theory study.
Thulesius HO, Scott H, Helgesson G, Lynöe N.
BMC Palliat Care. 2013 Mar 13;12:13. doi: 10.1186/1472-684X-12-13.
Abstract
BACKGROUND:Dying is inescapable yet remains a neglected issue in modern health care. The research question in this study was "what is going on in the field of dying today?" What emerged was to eventually present a grounded theory of control of dying focusing specifically on how people react in relation to issues about euthanasia and physician-assisted suicide (PAS). METHODS:Classic grounded theory was used to analyze interviews with 55 laypersons and health care professionals in North America and Europe, surveys on attitudes to PAS among physicians and the Swedish general public, and scientific literature, North American discussion forum websites, and news sites.RESULTS:Open awareness of the nature and timing of a patient's death became common in health care during the 1960s in the Western world. Open dying awareness contexts can be seen as the start of a weakening of a taboo towards controlled dying called de-tabooing. The growth of the hospice movement and palliative care, but also the legalization of euthanasia and PAS in the Benelux countries, and PAS in Montana, Oregon and Washington further represents de-tabooing dying control. An attitude positioning between the taboo of dying control and a growing taboo against questioning patient autonomy and self-determination called de-paternalizing is another aspect of de-tabooing. When confronted with a taboo, people first react emotionally based on "gut feelings" - emotional positioning. This is followed by reasoning and label wrestling using euphemisms and dysphemisms - reflective positioning. Rarely is de-tabooing unconditional but enabled by stipulated positioning as in soft laws (palliative care guidelines) and hard laws (euthanasia/PAS legislation). From a global perspective three shapes of dying control emerge. First, suboptimal palliative care in closed awareness contexts seen in Asian, Islamic and Latin cultures, called closed dying. Second, palliative care and sedation therapy, but not euthanasia or PAS, is seen in Europe and North America, called open dying with reversible medical control. Third, palliative care, sedation therapy, and PAS or euthanasia occurs together in the Benelux countries, Oregon, Washington and Montana, called open dying with irreversible medical control. CONCLUSIONS: De-tabooing dying control is an assumed secular process starting with open awareness contexts of dying half a century ago, and continuing with the growth of the palliative care movement and later euthanasia and PAS legislation.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3602181/pdf/1472-684X-12-13.pdf



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Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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